People with diabetes should plan their diet in consultation with a physician and a registered dietitian. Once a meal plan has been established, the primary methods that patients use to keep track of their carbohydrates are diabetic food exchange lists or carbohydrate (“carb”) counting.

There are pros and cons to each method. Diabetic food exchanges offer patients a simple way to plan a balanced diet with a variety of choices, while at the same time ensuring proper consumption of carbohydrates. They are likely to appeal to patients who like structure built into their meal planning.

On the other hand, some may find the range of choices in exchange lists to be too limiting. This is especially true for those who like to experiment with cooking, although many diabetic cookbooks break recipes down into the number of exchanges in a portion.

The method of carb counting is used to calculate the amount of insulin needed to convert a meal to energy. This is done by adding the amount of carbohydrates – in grams - within the meal a patient is preparing to eat. The numbers added come from the carbohydrate column of the list of diabetic exchanges.

Meanwhile, people who use carbohydrate counting can experiment with more varied food types and often find it more flexible than diabetic exchanges. However, patients who use this method instead of diabetic food exchange need to be more vigilant in planning well–balanced meals. Carbohydrate counting also involves math, which may be a drawback for some. For more information on carb counting, see carbohydrates.

Other methods that some people use include the glycemic index and load, the diabetes food pyramid and the “rate your plate” system.